Real-life practice of reflectance confocal microscopy in France: A prospective multicenter study

J Am Acad Dermatol. 2024 Jul;91(1):51-56. doi: 10.1016/j.jaad.2024.01.079. Epub 2024 Feb 20.

Abstract

Background: Studies demonstrating the potential utility of reflectance confocal microscopy (RCM) have been performed under experimental conditions.

Objective: To provide an overview of RCM practice in real-life.

Methods: A multicenter, prospective study carried out in 10 university dermatology departments in France.

Results: Overall, 410 patients were enrolled. One-half of the patients (48%) were referred by private practice dermatologists. They were referred for diagnosis (84.9%) or presurgical mapping (13%). For diagnosis, the lesions were located on the face (62%), arms and legs (14.9%), and trunk (13.6%), and presurgical mapping was almost exclusively on the face (90.9%). Among those referred for diagnosis, the main indication was suspicion of a skin tumor (92.8%). Of these, 50.6% were spared biopsies after RCM. When RCM indicated surgery, histology revealed malignant lesions in 72.7% of cases. The correlation between RCM and histopathology was high, with a correlation rate of 82.76% and a kappa coefficient of 0.73 (0.63; 0.82).

Limitations: This study was performed in the settings of French tertiary referral hospitals.

Conclusion: This study shows that in real-life RCM can be integrated into the workflow of a public private network, which enables a less invasive diagnostic procedure for patients.

Keywords: basal cell carcinoma; confocal microscopy; dermatopathology; lentigo/lentigo maligna; melanoma; public health.

Publication types

  • Multicenter Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Biopsy / statistics & numerical data
  • Dermatology / methods
  • Dermatology / statistics & numerical data
  • Female
  • France
  • Humans
  • Male
  • Microscopy, Confocal* / methods
  • Microscopy, Confocal* / statistics & numerical data
  • Middle Aged
  • Private Practice / statistics & numerical data
  • Prospective Studies
  • Referral and Consultation / statistics & numerical data
  • Skin Diseases / diagnosis
  • Skin Diseases / diagnostic imaging
  • Skin Diseases / pathology
  • Skin Neoplasms* / diagnosis
  • Skin Neoplasms* / diagnostic imaging
  • Skin Neoplasms* / pathology
  • Young Adult